也谈严重烧伤感染治疗

To intensify our understanding about management of severe burn infection

Nowadays, it is necessary to emphasize the three basic inseparable elements in the treatment of severe burn infection, which are systemic care, burn wound care, and ra-tional use of antimicrobia/s topically or systematically. Systemic care has been shifted from simple nutritional support to maintai-ning the systemic homeostasis, including balancing immune-in-flammatory response, and protecting organs from dysfunction.Some work focused on regulating systemic immune response in the initial phase and the balance of inflammatory response after occurrence of severe burn infection have been reported. These results at least broaden our thinking to recognize that treatment should not only destroy microbes, but also balance the response of the body. Escharectomy in earlier phase has been a consen-sus. Currently, we turn our vision into how to use "damage con-trol surgery (DCS)" concept in management of severe burn.DCS in burn care includes the evaluation of perioperative situa-tion more accurate to make a more appropriate surgical decision. Meanwhile, an overall strategy should be established to confront the rapidly increasing drug resistance of the pathogens. The re-lease of endotoxin after use of antimicrobials, which has been studied widely, should be explored further.